Advertisement

Digestive Diseases and Sciences

, Volume 54, Issue 12, pp 2736–2741 | Cite as

A 10-Year Follow-up of a Longitudinal Study of Gallstone Prevalence at Necropsy in South East England

  • Hamed N. Khan
  • Margaret Harrison
  • Eryl E. Bassett
  • Tom Bates
Original Article

Abstract

The purpose of this study was to examine a previous increase in male gallstone disease and to consider the burden of gallstones in a necropsy study with matched controls over a decade. Gallstone prevalence in 5,050 males fell from 20.2% to 19.1% (P = 0.022) and in 4,125 females fell from 30.4% to 29.0% (P = 0.03). Female gallstone subjects had a higher BMI than controls 24.5 vs. 23.3 (P < 0.01), but males did not. Gallstones were twice as common in diabetics, but not with coronary heart disease (CHD). A third of elderly patients of both sexes had gallstones, but cholecystectomy was more common in females, 17:10%. Gallstone-related mortality was 0.7%. The prevalence of gallstones fell slightly. The association between gallstones and diabetes was confirmed, but not for CHD, and for BMI this was confined to females. Gallstones are very common in the elderly, but most are unoperated and seldom cause death.

Keywords

Case control Cholecystectomy Coronary heart disease Diabetes Gallstones Necropsy Obesity Prevalence 

Notes

Acknowledgments

We thank Susan Bendall for data analysis and S. Paulvannan for data input. We thank the pathologists Dr M. King, Dr N. Padley and Dr C. Lawson.

References

  1. 1.
    Misciagna G, Centonze S, Leoci C, et al. Diet, physical activity, and gallstones - a population-based, case–control study in southern Italy. Am J Clin Nutr. 1999;69:120–126.PubMedGoogle Scholar
  2. 2.
    Nakeeb A, Comuzzie AG, Martin L, et al. Gallstones: genetics versus environment. Ann Surg. 2002;235:842–849. doi: 10.1097/00000658-200206000-00012.CrossRefPubMedGoogle Scholar
  3. 3.
    Vitetta L, Sali A, Little P, Mrazek L. Gallstones and gall bladder carcinoma. Aust NZ J Surg. 2000;70:667–673. doi: 10.1046/j.1440-1622.2000.01926.x.CrossRefGoogle Scholar
  4. 4.
    Freedman J, Ye W, Naslund E, Lagergren J. Association between cholecystectomy and adenocarcinoma of the esophagus. Gastroenterology. 2001;121:548–553. doi: 10.1053/gast.2001.27217.CrossRefPubMedGoogle Scholar
  5. 5.
    Lagergren J, Ye W, Ekbom A. Intestinal cancer after cholecystectomy: is bile involved in carcinogenesis? Gastroenterology. 2001;121:542–547. doi: 10.1053/gast.2001.27083.CrossRefPubMedGoogle Scholar
  6. 6.
    Reid FDA, Mercer PM, Harrison M, Bates T. Cholecystectomy as a risk factor for colorectal cancer: a meta-analysis. Scand J Gastroenterol. 1996;31:160–169. doi: 10.3109/00365529609031981.CrossRefPubMedGoogle Scholar
  7. 7.
    Mercer PM, Reid FDA, Harrison M, Bates T. The relationship between cholecystectomy, unoperated gallstone disease and colorectal cancer. Scand J Gastroenterol. 1995;30:1017–1020. doi: 10.3109/00365529509096347.CrossRefPubMedGoogle Scholar
  8. 8.
    Reshetnikov OV, Ryabikov AN, Shakhmatov SG, Malyutina SK. Gallstone disease prevalence in Western Siberia: cross-sectional ultrasound study versus autopsy. J Gastroenterol Hepatol. 2002;17:702–707. doi: 10.1046/j.1440-1746.2002.02758.x.CrossRefPubMedGoogle Scholar
  9. 9.
    Massarrat S. Prevalence of gallstone disease in Iran. J Gastroenterol Hepatol. 2001;16:564–567. doi: 10.1046/j.1440-1746.2001.02478.x.CrossRefPubMedGoogle Scholar
  10. 10.
    Bateson MC. Gallstones and cholecystectomy in modern Britain. Postgrad Med J. 2000;76:700–703. doi: 10.1136/pmj.76.901.700.CrossRefPubMedGoogle Scholar
  11. 11.
    Everhart JE, Khare M, Hill M, Maurer KR. Prevalence and ethnic differences in gallbladder disease in the United States. Gastroenterology. 1999;117:632–639. doi: 10.1016/S0016-5085(99)70456-7.CrossRefPubMedGoogle Scholar
  12. 12.
    McFarlane MJ. Supportive evidence for the validity of the epidemiologic necropsy for gallstones. J Gen Intern Med. 1990;5:495–500. doi: 10.1007/BF02600878.CrossRefPubMedGoogle Scholar
  13. 13.
    Jorgensen T, Rossen K, Thorvaldsen P. Are autopsy studies reliable in assessing gallstone prevalence in the community? Int J Epidemiol. 1994;23:566–569. doi: 10.1093/ije/23.3.566.CrossRefPubMedGoogle Scholar
  14. 14.
    Godfrey PJ, Bates T, Harrison M, King MB, Padley NR. Gallstones and mortality: a study of all gallstone related deaths in a single health district. Gut. 1984;25:1029–1033. doi: 10.1136/gut.25.10.1029.CrossRefGoogle Scholar
  15. 15.
    Bates T, Harrison M, Lowe D, Lawson C, Padley N. Longitudinal study of gall stone prevalence at necropsy. Gut. 1992;33:103–107. doi: 10.1136/gut.33.1.103.CrossRefPubMedGoogle Scholar
  16. 16.
    Diehl AK, Haffner AK, Hazuda HP, Stern MP. Coronary risk factors and clinical gallbladder disease: an approach to the prevention of gallstones? Am J Public Health. 1987;77:841–845. doi: 10.2105/AJPH.77.7.841.CrossRefPubMedGoogle Scholar
  17. 17.
    Mendez-Sanchez N, Bahena-Aponte J, Chavez-Tapia NC, et al. Strong association between gallstones and cardiovascular disease. Am J Gastroenterol. 2005;100:827–830. doi: 10.1111/j.1572-0241.2005.41214.x.CrossRefPubMedGoogle Scholar
  18. 18.
    Acalovschi M, Pascu M, Iobagiu S, et al. Increasing gallstone prevalence and cholecystectomy rate in a large Romanian town. A necropsy study. Dig Dis Sci. 1995;40:2582–2586. doi: 10.1007/BF02220445.CrossRefPubMedGoogle Scholar
  19. 19.
    Mendez-Sanchez N, Jessurun J, Ponciano-Rodriguez G, Alonso-de-Ruiz P, Uribe M, Hernandez-Avila M. Prevalence of gallstone disease in Mexico. A necropsy study. Dig Dis Sci. 1993;38:680–683. doi: 10.1007/BF01316800.CrossRefPubMedGoogle Scholar
  20. 20.
    Avgerinos DV, Bjornsson J. Malignant neoplasms: discordance between clinical diagnoses and autopsy findings in 3, 118 cases. APMIS. 2001;109:774–780. doi: 10.1034/j.1600-0463.2001.d01-145.x.CrossRefPubMedGoogle Scholar
  21. 21.
    Kratzer W, Mason RA, Kachele V. Prevalence of gallstones in sonographic surveys worldwide. J Clin Ultrasound. 1999;27:1–7. doi:10.1002/(SICI)1097-0096(199901)27:1<1::AID-JCU1>3.0.CO;2-H.CrossRefPubMedGoogle Scholar
  22. 22.
    Dhar SC, Ansari S, Saha M, et al. Gallstone disease in a rural Bangladeshi community. Indian J Gastroenterol. 2001;20:223–226.PubMedGoogle Scholar
  23. 23.
    Everhart JE, Yeh F, Lee ET, et al. Prevalence of gallbladder disease in American Indian populations: findings from the Strong Heart Study. Hepatology. 2002;35:1507–1512. doi: 10.1053/jhep.2002.33336.CrossRefPubMedGoogle Scholar
  24. 24.
    Rosmorduc O, Hermelin B, Poupon R. MDR3 gene defect in adults with symptomatic intrahepatic and gallbladder cholesterol cholelithiasis. Gastroenterology. 2001;120:1459–1467. doi: 10.1053/gast.2001.23947.CrossRefPubMedGoogle Scholar
  25. 25.
    Katsika D, Tuvblad C, Einarsson C, Lichtestein P, Marschall HU. Body mass index, alcohol, tobacco and symptomatic gallstone disease: a Swedish twin study. J Intern Med. 2007;262:581–587. doi: 10.1111/j.1365-2796.2007.01860.x.CrossRefPubMedGoogle Scholar
  26. 26.
    Volzke H, Baumeister SE, Alte D, et al. Independent risk factors for gallstone formation in a region with a high cholelithiasis prevalence. Digestion. 2005;71:97–105. doi: 10.1159/000084525.CrossRefPubMedGoogle Scholar
  27. 27.
    Tung TH, Ho HM, Shih HC, et al. A population-based follow-up study of gallstone disease among type 2 diabetics in Kinmen, Taiwan. World J Gastroenterol. 2006;12:4536–4540.PubMedGoogle Scholar
  28. 28.
    Tsai CJ, Leitzmann MF, Willett WC, Giovannucci EL. Central adiposity, regional fat distribution, and the risk of cholecystectomy. Gut. 2006;55:708–714. doi: 10.1136/gut.2005.076133.CrossRefPubMedGoogle Scholar
  29. 29.
    Caroli-Bosc FX, Pugliese P, Peten EP, et al. Gallbladder volume in adults and its relationship to age, sex, body mass index, body surface area and gallstones. An epidemiologic study in a nonselected population in France. Digestion. 1999;60:344–348.CrossRefPubMedGoogle Scholar
  30. 30.
    Chapman BA, Frampton CM, Wilson IR, Chisholm RJ, Allan RB, Burt MJ. Gallstone prevalence in Christchurch: risk factors and clinical significance. N Z Med J. 2000;113:46–48.PubMedGoogle Scholar
  31. 31.
    Borch K, Jonsson KA, Zdolsek JM, Halldestam I, Kullman E. Prevalence of gallstone disease in a Swedish population sample. Relations to occupation, childbirth, health status, life style, medications, and blood lipids. Scand J Gastroenterol. 1998;33:1219–1225. doi: 10.1080/00365529850172601.CrossRefPubMedGoogle Scholar
  32. 32.
    Mendez-Sanchez N, Zamora-Valdes D, Chaves-Tapia NC, Uribe M. Role of diet in cholesterol gallstone formation. Clin Chim Acta. 2007;376:1–8. doi: 10.1016/j.cca.2006.08.036.CrossRefPubMedGoogle Scholar
  33. 33.
    Shaffer EA. Gallstone disease: Epidemiology of gallbladder stone disease. Best Pract Res Clin Gastroenterol. 2006;20:981–986. doi: 10.1016/j.bpg.2006.05.004.CrossRefPubMedGoogle Scholar
  34. 34.
    Social trends 19, London: HMSO; 1989:118–22.Google Scholar
  35. 35.
    Kono S, Shinchi K, Ikeda N, Yanai F, Imanishi K. Prevalence of gallstone disease in relation to smoking, alcohol use, obesity, and glucose tolerance: a study of self-defense officials in Japan. Am J Epidemiol. 1992;136:787–794.CrossRefPubMedGoogle Scholar
  36. 36.
    Chapman BA, Chapman TM, Frampton CM, et al. Gallbladder volume: comparison of diabetics and controls. Dig Dis Sci. 1998;43:344–348. doi: 10.1023/A:1018810523399.CrossRefPubMedGoogle Scholar
  37. 37.
    Shinchi K, Kono S, Honjo S, Imanishi K, Hirohata T. Serum lipids and gallstone disease. A study of self-defense officials in Japan. Ann Epidemiol. 1993;3:614–618.PubMedCrossRefGoogle Scholar
  38. 38.
    Bateson MC. Gallbladder disease and cholecystectomy rate are independently variable. Lancet. 1984;2:621–624. doi: 10.1016/S0140-6736(84)90605-6.CrossRefPubMedGoogle Scholar
  39. 39.
    Plant JCT, Percy I, Bates T, Gastard J, DeNercy YH. Incidence of gallbladder disease in Canada, England and France. Lancet. 1973;2:249–251. doi: 10.1016/S0140-6736(73)93148-6.CrossRefPubMedGoogle Scholar
  40. 40.
    Shaper NL, Harrison M, Bates T. Impact of laparoscopic cholecystectomy on surgical training. Ann R Coll Surg Engl. 1996;78:39–42.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Hamed N. Khan
    • 1
  • Margaret Harrison
    • 2
  • Eryl E. Bassett
    • 3
  • Tom Bates
    • 2
    • 4
  1. 1.The Breast DepartmentRoyal Hallamshire HospitalSheffieldUK
  2. 2.Department of SurgeryWilliam Harvey HospitalAshford, KentUK
  3. 3.Institute of Mathematics & StatisticsUniversity of KentCanterburyUK
  4. 4.Ashford, KentUK

Personalised recommendations